慢性心力衰竭中的白蛋白尿:患病率和预后重要性
Colette E Jackson1, Scott D Solomon, Hertzel C Gerstein
1British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Lancet (London, England)
|August 18, 2009
概括
在心力衰竭患者中,尿白蛋白与肌素比率 (UACR) 的增加预示着不良结果,即使在没有糖尿病或高血压的患者中也是如此. 这一发现强调了UACR作为心力衰竭预后的关键预后标志物.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床医学 临床医学
背景情况:
- 专性尿症,以尿中的专蛋白与肌素比率 (UACR) 的增加表示,与心力衰竭的病理生理变化有关.
- 评估UACR的患病率和预后意义对于了解心力衰竭进展至关重要.
研究的目的:
- 为了确定心力衰竭患者增加UACR的患病率.
- 评估UACR对心血管结果和全因死亡率的预后价值.
主要方法:
- 这项研究分析了2310名来自心力衰竭中的Candesartan:评估减少死亡率和发病率 (CHARM) 计划的患者的UACR.
- 评估了微专尿和大专尿的患病率,以及UACR对心血管死亡或心力衰竭住院治疗和全因死亡的预测值.
主要成果:
- 58%的患者有正常的UACR,30%的患者有微专尿,11%的患者有宏专尿.
- 升高的UACR与老年,更多的并发症,较差的功能和较高的糖尿病患病率有关.
- 经过调整后的分析证实UACR升高是不良结果的独立预测因子,微专尿和宏专尿组与正常专尿组相比,复合结果和死亡的危险比率显著更高.
结论:
- 增加的UACR是心力衰竭患者预后的强大和独立预测因素.
- 即使在没有糖尿病,高血压或功能障碍的患者中,UACR的预后价值仍然存在.
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